March 28, 2011 -- Cyberbullying, sexting, and so-called Facebook depression are a few of the reasons parents should tune in to what their teens and tweens are doing on social networking sites, pediatricians say.

A new clinical report, published in Pediatrics, outlines some of the key benefits and risks of social networking. It stresses the need for parents not only to talk to their kids about specific risks, but to participate with their kids on sites like MySpace and Twitter, rather than to leave monitoring up to software programs.

“Some young people find the lure of social media difficult to resist, which can interfere with homework, sleep, and physical activity,” says Gwenn Schurgin O’Keefe, MD, a Wayland, Mass.-based pediatrician, blogger, and health writer who co-authored the guidelines. “Parents need to understand how their child is using social media so they can set appropriate limits.”

O’Keefe is no dilettante in matters of adolescents and their cyber lives, either.

“I’ve had a few ‘a-ha’ moments as a mom with technology,” she tells WebMD.

She once had to summon her daughter to dinner via instant message after repeatedly calling, and failing, to steal her attention away from an online chat session.

“It was like she had become fused with the computer. She was so absorbed in what she was doing she was just tuned out,” O’Keefe says.

Parents Not Keeping Up

The new guidelines come on the heels of recent surveys that have revealed what appears to be a significant communication gap between parents and kids about social networking.

A report released by Australian researchers earlier this week, for example, which surveyed more than 1,000 middle-school-aged kids and their parents and teachers about online habits, found that nearly 95% used social networking sites, most often Facebook.

And while about half said they knew there was some element of risk in networking online, more than one in four considered the sites to be safe.

What’s more, almost half the students surveyed reported that they had not talked to their parents about their use of social networking sites, and nearly three-quarters said they hadn’t spoken to a teacher about it. About 80% of the parents in that survey said they had seen their child’s profile page at least once, however.

Similarly, a 2009 poll by the group Common Sense Media, a San Francisco-based think tank that explores issues surrounding media use in youths, which questioned more than 2,000 teens and their parents about social networking, found that nearly one in four teens check these sites more than 10 times a day. Just 4% of parents knew that, however. About one in eight teens with Facebook or MySpace pages said that their parents didn’t know about the account.

When it comes to sexting, the practice of sending sexually explicit pictures or messages, a nationwide poll commissioned by the National Campaign to Prevent Teen and Unplanned Pregnancy and the magazine CosmoGirl found that 22% of teenage girls and 18% of teenage boys said they had posted or sent nude or semi-nude pictures or video of themselves. Thirty nine percent said they had posted explicit messages. Sixty-eight percent, however, said that disappointing family members would be a reason to be concerned about doing that.

Benefits and Risks of Sharing in Cyberspace

In setting up the new guidelines for doctors to talk to patients and their parents about social networking, the report stresses that there are plenty of healthy reasons to connect online, including nurturing friendships and community engagement. Community engagement includes such areas as raising money for charity or getting involved in the political process, learning in virtual classrooms, and even taking advantage of the privacy afforded by the Internet to get answers about health issues that might be hard to bring up face to face.

But there can be significant downsides, too.

In particular, negative interactions like cyberbullying and harassment can lead to depression, anxiety, severe isolation, and even suicide.

In the Common Sense Media poll, one in five teens admitted to sexting, which can have legal consequences. The report notes cases of teens charged with felony child pornography and labeled as sex offenders for passing explicit messages or pictures.

Still other studies have investigated a relatively new phenomenon called “Facebook depression” -- signs of depression that develop after young adults spend a great deal of time on social media sites.

A lack of boundaries coupled with a lack of sophistication about privacy controls on sites that may lead to a lasting loss of privacy is also a problem for kids online, the report found.

“As a result,” the authors write, “future jobs and college acceptance may be put into jeopardy by inexperienced and rash clicks of the mouse.”

In the Common Sense Poll, for example, 16% of parents said they thought their child had shared information online they might not normally share in public while 28% of kids admitted to oversharing.

“This is a good recommendation for pediatricians and parents to have a conversation to encourage parents to be more involved in their children’s lives. And for kids and youth these days the online domain is really important to them, so it makes sense,” says Amori Yee Mikami, PhD, a clinical psychologist and assistant professor at the University of Virginia, who was not involved in developing the new guidelines.

Some Kids More Vulnerable Online Than Others

Mikami and colleagues assessed the friendships and popularity of 172 13- and 14-year-olds from the same school, and then friended those kids eight years later on Facebook and MySpace to study how they were interacting.

They found that those who were happy and well-adjusted in the real world were most likely to be getting along well in the virtual one.

And kids who struggle with relationships at school and home are likely to be struggling with social networking, too.

“It’s the same kids who are at risk for problematic social interactions face to face, at the mall, at school in after school activities; it’s probably the same category of youth at risk,” Mikami says.

“Things to watch out for would probably be youth who are displaying other types of psychopathology like depression, anxiety, aggressive behavior, or delinquent behavior, who seem to be hanging out with the wrong kids or kids who are loners and don’t seem to have friends or good friends or who get picked on or teased a lot,” she tells WebMD.

What Parents Can Do

One reason there isn’t better communication between kids and parents about social media, O’Keefe thinks, is that kids look like computer whizzes, and parents may equate technological prowess with social savvy.

“They forget that use of technology and the ability to handle the technical side, doesn’t mean they can handle the social side and all the nuances of technology,” she says. “That’s where parents and their life experience comes in.”

Talking is the place to start.

Key issues to bring up, the authors say, are privacy controls on sites and why they’re important; the kinds of pictures and messages that are appropriate, or not, to post; and the nature of advertising on social networking sites, which can masquerade as games or other kinds of entertainment.

It’s also important for parents to respect the age limits on sites like Facebook, which restricts use to kids over the age of 13, in line with federal privacy laws.

“If you have somebody who’s not 13 on a site for kids over 13, they’re served up content in a multitude of ways,” O’Keeffe says, “so they’re influenced by a bombardment of material and that’s going to influence their choices, how they think and how they act, and that has direct consequences on their health.”

“Then you add to it that their parents are knowingly letting them do it. That is huge, because it says to them, ‘You can lie here,’” she says, stressing that duplicity undermines parental authority.

The solution, she feels, is for parents to stand firm.

“There are rites of passage in life. You have to be 21 to have a drink, 18 to vote, 16 to get your learner’s permit, and in terms of Facebook, you have to be 13,” O’Keefe says.